Case report: The management of advanced oral cancer in a Jehovah's Witness using the Ultracision Harmonic Scalpel

Abstract

We present the first case of a head and neck oncological procedure accomplished in a Jehovah's Witness using the Ultracision Harmonic Scalpel (Ethicon, Cincinnati, OH). Jehovah's Witnesses present a serious challenge to the head and neck cancer surgeon due to their refusal to accept transfusion of any blood products. However, our experience reinforces the view that surgical management of head and neck cancer is possible in these patients. We show the Harmonic Scalpel, an ultrasonic tissue dissector, to be a useful surgical tool in obviating the need for blood transfusion. Preoperative optimisation, intra-operative surgical and anaesthetic techniques are also fully discussed.

Total Knee Arthroplasty Is Safe in Jehovah's Witness Patients—A 12-Year Perspective

“…Comprehensive preoperative screening and administration of hematopoietic stimulants, [9][10][11][12][13] clotting factors, 14,15 and RBC precursors 9,16,17 aim to optimize hemodynamics prior to surgery. The use of diathermy dissection, 17 hemostatic instruments, 18 limb tourniquets, 19 vascular occlusion devices, 20,21 hemostatic sealants, 22 and prohemostatic agents 10,12,23 have been demonstrated to reduce intraoperative blood loss. Hypotensive anesthesia, 24,25 hemodilution, 14,26 and autologous intraoperative blood salvage 27,28 further limit perioperative bleeding in JW.…”